title: Ureteral injury after posterior lumbar discectomy with interbody screw fixation.
abstract: We report a case of iatrogenic ureteral injury secondary to L5 laminectomy and microdiscectomy with L5-S1 bone graft with posterior lumbar interbodyfusion using presacral cancellous screw fixation, managed by initial ureteral stent placement and subsequent Boari bladder flap repair. A 33-year-old woman underwent L5 laminectomy and microdiscectomy with L5-S1 bone graft with posterior lumbar interbody fusion using presacral cancellous screw fixation. On postoperative day 10, she developed lower abdominal pain, vomiting and fever. Ultrasonogram and contrast-enhanced CT demonstrated a large pelvic urinoma secondary to a right lower ureteric injury. This was managed initially by ureteral stent placement and subsequent Boari bladder flap repair. Ureteral injury following spinal surgery is a rare surgical complication with significant morbidity and mortality. A high index of suspicion is essential for early appropriate management and renal salvage.
authors.affiliation: Department of Urology, KMC Manipal, Manipal University, Manipal, Karnataka, India.
authors.forename: Sunil Bhaskara
authors.initials: SB
authors.lastname: Pillai
authors.forename: Padmaraj
authors.initials: P
authors.lastname: Hegde
authors.forename: Giridhar
authors.initials: G
authors.lastname: Venkatesh
authors.forename: Bhalaguru
authors.initials: B
authors.lastname: Iyyan
mesh_terms: D000328:Adult; D001863:Bone Screws; D016025:Bone Transplantation; D017586:Diskectomy / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007796:Laminectomy; D008159:Lumbar Vertebrae / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation*; D015607:Stents; D014513:Ureter / Q000293:injuries*